Behavioral Health Information and Guidance<
This section primarily addresses behavioral health response issues, including behavioral health aspects of public health emergencies, behavioral health countermeasures to pandemic influenza, behavioral health lessons learned from the Severe Acute Respiratory Syndrome (SARS) epidemic, and ways behavioral health can support public health measures in the event of an influenza pandemic.
Center for the Study of Traumatic Stress. (n.d.). Mental health and behavioral guidelines for response to a pandemic flu outbreak. Retrieved January 12, 2009, from http://www.centerforthestudyoftraumaticstress.org/downloads/CSTS_Pandemic_flu.pdf.
This guidance addresses mental health preparedness and response for pandemic influenza.
Reissman, D., Watson, P., Klomp, R., Tanielian, T., & Prior, S. (2006). Pandemic influenza preparedness: Adaptive responses to an evolving challenge. Journal of Homeland Security and Emergency Management, 3(2), Article 13.
This article addresses behavioral and emotional countermeasures to pandemic influenza.
Electronic copies may be downloaded at http://www.bepress.com/jhsem/vol3/iss2/13.
Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services. (2006). Helping to heal: Behavioral health planning and response to public health emergencies. Retrieved January 12, 2009, from http://www.dmhmrsas.virginia.gov/documents/cwd-helptohealbehaviorhealthpubhlthemerg.pdf.
Virginia developed this manual on the behavioral health aspects of public health emergencies. The manual primarily addresses pandemic influenza.
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Isolation and Quarantine<
Much of what is known regarding the behavioral health implications of isolation and quarantine comes from the SARS epidemic. Several articles in this section address the impact of SARS and SARS-associated isolation and quarantine on healthcare workers and on the general population. This section examines both the behavioral health impact of isolation and quarantine, as well as ways that behavioral health interventions can support public health isolation, quarantine, and social distancing measures.
Bulling, D., Zagurski, R., & Hoffman, S. (2007). Behavioral health guidelines for medical isolation. Retrieved January 12, 2009, from http://www.disastermh.nebraska.edu/files/publications/bh%20isolation%20protocol%20template.pdf.
This document presents behavioral health guidelines for use with hospital isolation precautions including guidelines addressing patients, staff, family members, and the community.
Hawryluck, L., Gold, W., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases, 10, 1206–1212. Retrieved January 12, 2009, from http://www.cdc.gov/ncidod/eid/vol10no7/03-0703.htm.
This article describes the prevalence of symptoms of posttraumatic stress disorder and depression among people who were quarantined in Toronto due to SARS.
Lau, J., Yang, X., Pang, E., Tsui, H., Wong, E., & Wing, Y. (2005). SARS-related perceptions in Hong Kong. Emerging Infectious Diseases, 11, 417–424. Retrieved January 12, 2009, from http://www.cdc.gov/ncidod/eid/vol11no03/04-0675.htm.
This article describes perceptions of the general public in Hong Kong about the SARS epidemic including self-reports of the psychological and behavioral impact.
Loutfy, M., Wallington, T., Rutledge, T., Mederski, B., Rose, K., Kwolek, S., et al. (2004). Hospital preparedness and SARS. Emerging Infectious Diseases, 10, 771–776. Retrieved January 12, 2009, from http://www.cdc.gov/ncidod/eid/vol10no5/03-0717.htm.
Part of this article addresses the psychological and psychosocial management of the SARS crisis in a Toronto hospital.
Maunder, R., Lancee, W., Balderson, K., Bennett, J., Borgundvaag, B., Evans, S., et al. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases, 12, 1924–1932. Retrieved January 12, 2009, from http://www.cdc.gov/ncidod/sars/pdf/isolationquarantine.pdf.
This article describes the long-term psychological and behavioral effects of the SARS epidemic among Toronto healthcare workers.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2004). Isolation and quarantine [Fact sheet]. Retrieved January 12, 2009, from http://www.cdc.gov/ncidod/sars/pdf/isolationquarantine.pdf.
This basic fact sheet from the Centers for Disease Control and Prevention (CDC) addresses isolation and quarantine.
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Planning<
This section addresses a variety of pandemic influenza behavioral health planning resources. Some planning tools, such as the pandemic influenza tabletop exercise, are specific to behavioral health. Others, such as the CDC Webcasts and planning checklists, address some behavioral health issues.
American Public Health Association. (2007). Policy summary: APHA’s prescription for pandemic flu. Retrieved January 12, 2009, from http://www.apha.org/nr/rdonlyres/d5017db9-f400-4399-a656-939c4c8df259/0/flupolicycomplete.pdf.
This policy summary from the American Public Health Association describes seven policy areas including incorporating mental health into pandemic influenza preparedness and response plans.
Hansen, K. (2006). Nebraska behavioral health tabletop situation manual: Avian influenza. Omaha, NE: Center for Biopreparedness Education. Retrieved January 12, 2009, from http://www.disastermh.nebraska.edu/files/publications/NE%20BH%20Tabletop%20Situation%20Manual.pdf.
This tabletop exercise examines the role of behavioral health in response to an avian influenza outbreak in a community that relies on the poultry industry. Included among the objectives are National Incident Management System compliance issues, identifying physical resources needed by behavioral health personnel, and identifying the role of risk communications.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2005). State and local pandemic influenza planning checklist. Retrieved January 12, 2009, from http://pandemicflu.gov/plan/pdf/checklist.pdf.
This State and local pandemic influenza planning checklist includes a few psychosocial workforce support planning considerations from the U.S. Department of Health and Human Services (HHS) Supplement 11.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2006). Long-term care and other residential facilities pandemic influenza planning checklist. Retrieved January 12, 2009, from http://pandemicflu.gov/plan/pdf/longtermcare.pdf.
This planning checklist can be adapted by behavioral health residential facilities to help develop a pandemic influenza plan.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2006). Public health grand rounds, pandemic flu preparedness: What every community should know [Webcast]. Retrieved January 12, 2009, from http://www2.cdc.gov/phtn/webcast/phgr-92906/default.asp.
This Webcast was produced by the CDC September 29, 2006, and focuses on pandemic influenza community preparedness. The Webcast highlights, in part, the pandemic influenza planning of Santa Clara County, CA, with representation from the county’s public health, mental health, and emergency management officials.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2007). Interim pre-pandemic planning guidance: Community strategy for pandemic influenza mitigation in the United States—early, targeted, layered use of nonpharmaceutical interventions. Retrieved January 12, 2009, from http://www.pandemicflu.gov/plan/community/community_mitigation.pdf.
This guidance describes how nonpharmaceutical interventions such as isolation, quarantine, and child and adult social distancing may be implemented. Behavioral health has a role in supporting interventions such as these.
U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2007). Pandemic influenza: Progress in planning and exercising federal, state, and local perspectives [Webcast]. Retrieved January 12, 2009, from http://www2.cdc.gov/phtn/webcast/influenza07/media.asp.
This Webcast was produced by the CDC April 5, 2007, and while it does not focus on behavioral health, it provides an update of CDC’s pandemic influenza preparedness activities. Highlights that could be of interest to behavioral health professionals include New York City’s Point of Distribution influenza vaccination exercise in which mental health personnel participated, a mock newscast that could be used as part of a tabletop exercise, a discussion of nonpharmaceutical interventions, and a question regarding providing support to children.
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Plans<
The plans highlighted here represent a variety of behavioral health pandemic influenza planning approaches and are not meant to recommend the quality of one plan over another. Although an influenza pandemic would impact the entire Nation, its primary consequences will be felt on the local level. Therefore, State and local communities are developing pandemic influenza plans that address unique needs such as immigrant populations, border health, and opioid treatment provider planning. While some pandemic influenza plans contain annexes or sections devoted to behavioral health, others have behavioral health content that is integrated into various parts of the plan. In addition, some State mental health and substance abuse agencies are developing agency pandemic influenza plans to address behavioral health response and continuity of operations issues. Some of the plans highlighted here are in draft form and will be updated as new plans become available. To access currently available State and Territory pandemic influenza plans, please use the "State pandemic influenza plans" link on the Helpful Links page.
Arizona Department of Health Services, Division of Behavioral Health Services. (2006). Arizona influenza pandemic response plan supplement 11: Workforce support—psychosocial considerations and information needs. Retrieved January 12, 2009, from http://www.azdhs.gov/pandemicflu/pdf/supp_11_workforce_support.pdf.
This psychosocial workforce support plan from Arizona focuses on psychosocial support services, workforce support materials, and workforce resilience programs.
California Department of Alcohol and Drug Programs. (2006). Department of Alcohol and Drug Programs pandemic influenza preparedness and response annex. Sacramento, CA: California Department of Alcohol and Drug Programs.
This annex from California addresses continuity of operations, response, and staff safety issues.
Electronic copies may be downloaded at http://www.samhsa.gov/csatdisasterrecovery/preparedness/08-ADPPandemicFluPlanFinal5-06%202.pdf.
Massachusetts Department of Public Health, Center for Emergency Preparedness. (2005). Pandemic influenza continuity of operations plan (COOP) for Massachusetts hospitals. Retrieved January 12, 2009, from http://www.mass.gov/Eeohhs2/docs/dph/emergency_prep/hospital_coop.pdf.
This COOP addresses the unique planning assumptions related to pandemic influenza.
New York City Department of Health and Mental Hygiene. (2006). New York City Department of Health and Mental Hygiene pandemic influenza preparedness and response plan. Retrieved January 12, 2009, from http://www.nyc.gov/html/doh/downloads/pdf/cd/cd-panflu-plan.pdf.
Section Eight of New York City’s pandemic influenza preparedness and response plan addresses mental health and focuses on responding to the psychological impact of pandemic influenza on the general population, as well as identifying vulnerable populations. The New York City plan is presented in its entirety due to the integration of behavioral health in several sections of the plan.
North Carolina Division of Mental Health/Developmental Disabilities/Substance Abuse Services. (2007). North Carolina pandemic influenza plan: Appendix M-1, Division of Mental Health/Developmental Disabilities/Substance Abuse Services influenza pandemic response. Retrieved January 12, 2009, from http://www.epi.state.nc.us/epi/gcdc/pandemic/AppendixM1_2007.pdf.
This pandemic response plan for North Carolina’s behavioral health agency focuses on responding to the psychosocial impact of pandemic influenza among healthcare workers, responders, and the general public. Special-needs populations also are identified.
Santa Clara Valley Health and Hospital System, Santa Clara County, California Public Health Department. (2006). Pandemic influenza preparedness and response plan draft. Retrieved January 12, 2009, from http://www.sccgov.org/SCC/docs%2FPublic%20Health%20Department%20(DEP)%2Fattachments%2FPanFluPlan_SCC.pdf.
This pandemic influenza response plan contains a psychosocial support module that was developed in collaboration with the public and private mental health sectors. According to this plan, psychosocial support services will be targeted to healthcare workers and their families, current and new mental health clients, and members of the general community. Planning issues related to special populations are integrated throughout the entire plan.
Texas Department of State Health Services. (2005). Texas Department of State Health Services pandemic influenza preparedness plan draft. Retrieved January 12, 2009, from http://www.dshs.state.tx.us/idcu/disease/influenza/pandemic/draft_pipp_10_24_web.pdf.
Behavioral health issues are integrated into various components of the Texas plan including planning and coordination, situation monitoring and assessment, prevention and containment, health systems response, and communications.
U.S. Department of Health and Human Services. (2006). Supplement 11 workforce support: Psychosocial considerations and information needs. Retrieved January 12, 2009, from http://www.hhs.gov/pandemicflu/plan/pdf/S11.pdf.
Supplement 11 of the HHS Pandemic Influenza Plan addresses the pandemic influenza-related psychosocial needs of healthcare workers and other responders.
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Psycho-Education<
This section contains a variety of psycho-educational pandemic influenza resources. Because the effects of an influenza pandemic will primarily be felt on the local level, many of these fact sheets have been developed by States and local communities. Psycho-educational resources from national organizations are also included. While many of these fact sheets address coping with the potential behavioral health impact of an influenza pandemic, others offer preparedness information. Behavioral health can support public health measures such as isolation, quarantine, and social distancing. Therefore, the risk communications guide can be used to help inform public psycho-educational campaigns and public health messages.
American Psychological Association. (2006). Preparing for bird flu [Tip sheet]. Retrieved January 12, 2009, from http://www.apahelpcenter.org/articles/pdf.php?id=142.
This tip sheet from the American Psychological Association addresses concern about avian influenza and ways to cope.
American Red Cross. (n.d.). Preparing for a flu pandemic fact sheet: Coping and emotional well-being. Retrieved January 12, 2009, from http://www.nmi.redcross.org/media/pan_flu_coping_emotional_well-being.pdf.
This fact sheet from the American Red Cross addresses ways to cope including preparedness and resilience strategies.
Center for the Study of Traumatic Stress. (n.d.). Stress management for health care providers. Retrieved January 12, 2009, from http://www.centerforthestudyoftraumaticstress.org/downloads/CSTS_SressMgtHCProv.pdf.
The Center for the Study of Traumatic Stress developed this stress management tip sheet for healthcare workers.
Interchurch Ministries of Nebraska. (n.d.). Preparation for pandemic influenza in communities of faith. Retrieved January 12, 2009, from http://www.disastermh.nebraska.edu/files/pandemicinfluenza/RSV%20Pandemic%20Preparedness%202.pdf.
This tip sheet addresses how communities of faith can prepare for pandemic influenza, as well as ways they can offer support during an influenza pandemic.
National Child Traumatic Stress Network. (2008). Pandemic flu fact sheet: A parents’ guide to helping families cope with a pandemic flu. Retrieved April 20, 2009 from http://www.nctsn.org/nctsn_assets/pdfs/Pandemic_Flu_Factsheet.pdf.
This fact sheet provides basic information on pandemic flu and what you can do to help your family cope.
New Jersey Department of Human Services. (n.d.). Coping with your emotions during public health emergencies. Retrieved January 12, 2009, from http://www.disastermentalhealthnj.com/Pub%20Health_MH%20Brochure_rev.doc.
The New Jersey Department of Human Services developed this tip sheet that addresses typical reactions to public health emergencies and ways to cope.
New Jersey Department of Human Services, Division of Mental Health Services, Disaster and Terrorism Branch. (2006). Coping with the emotional challenges of pandemic influenza: An online guide for individuals and families [Slide presentation]. Retrieved January 12, 2009, from http://www.disastermentalhealthnj.com/Pandemic%20Influenza-Family%20Issues%20Version%20NJ%204-LBJvers.ppt.
This presentation from the New Jersey Division of Mental Health Services, Terrorism and Disaster Branch, provides an overview of pandemic influenza, a description of the emotional challenges, and strategies for coping.
Ohio Department of Health. (2007). What to tell kids about avian (bird) flu [Tip sheet]. Retrieved January 12, 2009, from http://www.ohiopandemicflu.gov/docs/TalkingKidsBirdFlu.pdf.
This tip sheet from the Ohio Department of Health offers suggestions on talking to children about avian influenza.
Ohio Departments of Health and Mental Health. (n.d.). Diminishing the anxiety of pandemic influenza [Fact sheet]. Retrieved January 12, 2009, from http://b9962ed140049a571a710839f1f71c989aaf09ce.gripelements.com/pdf/what-we-do/provide/emergency-preparedness/pandemic-flu-provider-information.pdf.
This pandemic influenza fact sheet is geared toward behavioral health providers and is the result of collaboration between the Ohio Departments of Health and Mental Health.
Ohio Departments of Health and Mental Health. (n.d.). Pandemic influenza: Behavioral health tips on how to prepare [Tip sheet]. Retrieved January 12, 2009, from http://b9962ed140049a571a710839f1f71c989aaf09ce.gripelements.com/pdf/what-we-do/provide/emergency-preparedness/pandemic-flu-public-information.pdf.
This tip sheet, developed by Ohio, describes possible behavioral health symptoms and ways to cope.
Santa Clara Valley, California Health and Hospital System, Public Health Department. (n.d.). Your guide to preparing for pandemic flu. Retrieved January 12, 2009, from http://www.sjsu.edu/hr/docs/risk/info/pandemic.pdf.
This guide from Santa Clara County, CA, offers information on pandemic influenza preparedness for individuals and families.
U.S. Department of Health and Human Services. (2006). Pandemic influenza pre-event message maps. Retrieved January 12, 2009, from http://www.pandemicflu.gov/news/pre_event_maps.pdf.
This HHS risk communications guide can help inform public psycho-educational campaigns regarding pandemic influenza.
Washington County, Oregon, Department of Health and Human Services. (n.d.). Pandemic flu and you: Mental health support during and after a flu pandemic [Fact sheet]. Retrieved January 12, 2009, from http://www.co.washington.or.us/deptmts/hhs/comm_hlh/panflu/general/mental_health.pdf.
This fact sheet describes possible mental health reactions to an influenza pandemic in children and adults and ways to cope.
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